DELTA International in Membership Application Form

The membership application should filled out legibly and completely. The duplicate copy should be detached for the chapter's files. The chapter should mail the top form to Omicron Delta Epsilon, P.O. Box 2096, Fairhope, AL 36533, along with the membership fee of $40 .00 for each initiate. The membership scrolls and cards will be MAILED TO THE FACULTY ADVISOR FOR DISTRIBUTION. You must ensure this form and pricing is current before submission. Check www.omicrondeltaepsilon.org/membership.html for the latest version.

PLEASE PRINT Chapter Name College/University Type of Membership (Check One) ❑ Undergraduate ❑ Graduate ❑ Faculty ❑ Charter ❑ Honorary ❑ Alumni

Member's Name (Mr. or Ms.)

Mailing Address City State Zip

Initiation Date (Day, Month, Year)

❑ THE AMERICAN Print option $20 Free electronic access to The American Economist will be granted all new members. Members can, however, choose two print issues instead at a reduced cost of $20 per year.

❑ Email Address (REQUIRED for free online access):

Omicron Delta Epsilon JEWELRY — Wear It With Pride! Please specify the jewelry item you desire by checking the appropriate box. (Jewelry will be delivered to address above in 4 - 6 weeks)

Gold Kase ❑ KEY CHARM ❑ KEY PIN ❑ KEY TIE TACK $25.00 For more ODE merchandise, please visit our website: www.omicrondeltaepsilon.org.

MEMBERSHIP SCROLL PLAQUE

The official Membership Scroll for Omicron Delta Epsilon ❑ PLAQUE $35.00 is pictured here framed in our Walnut-Finished Plaque. Each plaque is 11 1/2 x 14 inches in size, has a crystal clear acrylic covering, and comes ready for assembly in seconds. To order one for your membership scroll, check the appropriate box. The plaque cannot be shipped to a foreign address.

Shipping address for plaque if different from above: ______

YOUR REMITTANCE FOR THE ABOVE ITEMS MUST BE ENCLOSED WITH THIS APPLICATION ALONG WITH YOUR DUES.

APPLICATION AND ALL FEES MUST BE SUBMITTED BY THE FACULTY ADVISOR TOGETHER WITH A SIGNED A-1 FORM. Omicron Delta Epsilon PO Box 2096 Fairhope AL 36533 [email protected] www.omicrondeltaepsilon.org Updated 77/1/201